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Although in Favera'scase stated that there remained only a small recto-Vaginal fistula, yet the particulars coursework in regard the case are too few justify the belief that here also there occurred cure an anus prasternat.

vag. In regard diagnosis must first establish the fact that the abnormal communication with the small intestine, and next that due to complete opening an end the intestine and not a partial defect in the wall.

The first point proved the nature the intestinal help on writing a thesis statement contents, which consist not fasces, as in case a recto vaginal fistula, but chyme.

Fascal matter and foul odor may, however, present, and then in addition the intestinal contents, must note the rapidity with which the characteristic ingesta appear at the fistula. In case fistula the small intestine, characteristic remnants the ingesta may be passed the abnormal opening one two hours after a meal. To test this point, among other means, the lycopodium seeds answer well, for they are readily recognized in the intestinal contents. On the other hand the absence a communication between the rectum and the vagina may proved inserting a speculum into the rectum and injecting milk or colored fluid, which in case there exists a recto-vaginal fistula, will pass out the vagina.

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The sunken abdomen, the extreme emaciation, the hunger, these speak for the seat the fistula being the small intestine.

That the communication the result an anus prseternat.

and not of an ileo vag. fistula proved the existence help me write my personal statement two openings into the vagina, separated a projecting spur. If, as in Cassamayor's case, there but one opening, the examination with the sound better, with the finger will prove that the lumen patent in only one direction, and this speaks for anus prasternat. and also the history that the abnormal communication followed the loss a prolapsed coil intestine.

Weber and von Heine best essay services have devised and followed a method treatment anus prasternat.

ileo vag.

which fulfills every indication. It aims at restoring the lumen the intestinal canal, and then at the closure of the fistulous opening into the vagina. Weber formulated the first steps the method, and after his death Heine completed and obtained a perfect result. First the blades a writing help for college modified Dupuytren's intestinal scissors were inserted into the upper and the i need help writing a personal best dissertations essay lower openings the intestine the extent one and a half inches. The spur between the blades was then cut through screwing them together and leaving them till the aim was secured. With the separation the spur the lumen was opened and the anus prseternat. was converted into an ileo-vag. fistula. Then the opening between the intestine and the vagina was denuded and sutured even as in case a simple recto vaginal fistula.